Community Support Service

What is Traumatic Brain Injury?

Traumatic brain injury is injury of the brain resulting from mechanical trauma.

Causes

Traffic accidents, falls, home and industrial accidents are the most common causes of traumatic brain injury.

• Brain contusion/concussion
  • Even if the patient’s skull bone is intact, the impact on head may be strong enough to result in shearing, twisting and tearing of brain tissue, or in shaking to varying degrees. The former situation is referred as cerebral contusion and the latter as cerebral concussion.
• Brain laceration
  • When a break in the skull bone occurs, the skull fractures and bone fragments may cause blood clots in or around the brain that are classified by the location into epidural, subdural or intracerebral hematoma.

Common symptoms

The signs and symptoms of traumatic brain injury will depend on the type, location and severity of the brain damage. Generally speaking, the larger the area of brain damage, the more severe of the signs and symptoms.

• Motor dysfunction
  • The patient may have physical deficit including ambulation, balance, coordination, fine motor skills, strength, and endurance. At the same time, there may be deficits of language and communication. In addition, patients tend to be easily exhausted with slow reaction and work speed.
• Cognitive impairment
  • Ignore information from one side of the body
    Signs: The patients ignore or are not aware of half of their body and objects on the affected field of vision.
    Cause: Damage in brain causing the patient cannot see the entire field of vision.
  • Left-right imbalance and spatial disorientation
    Signs: The patients cannot distinguish left and right, and easily confused in space and direction.
    Cause: Damage in parietal lobe affects the ability to process and integrate multiple sensory information
  • Reading and writing disorder
    Signs: Patients cannot distinguish text
    Cause: Damaged parietal lobe
  • Facial ignorance
    Signs: The patients loss the ability to recognize and put togetehr facial details causing difficulty recognizing familiar people
    Cause: Damaged parietal lobe
  • Expressive aphasia (Broka’s aphasia)
    Signs: characterized by partial loss of the ability to produce language, although the patients’ hearing and comprehension generally remains intact. The patients cannot find appropriate words to express themselves and exhibit effortful speech.
    Cause: Damage to the posterior of the left frontal lobe
  • Anterograde amnesia
    Signs: decreased abilitiy to retain new information.
    Causes: Damage to the temporal lobe
  • Lack of spontaneity
    Signs: Although the patients know what and how to complete an assigned task, they often cannot start to work spontaneously
    Cause: Damage to the frontal lobe
  • Repetitive behavior
    Signs: keep repeating the same action. For example, when a patient copies a document, he or she will copy only the first line repeatedly
    Cause: inhibiitory control diminished after frontal lobe damage
  • Lack of self-awareness
    Signs: The patients are unaware of their changes in behavior or cognition
    Causes: Damage to the frontal lobe
  • Lack of organization and flexibility
    Signs: The patients fail to plan and execute goals when slightly complicated matters are encountered
    Cause: Damage to the frontal lobe
• Emotional and social disorders
  •  significant changes in emotional and social skills
    Signs: Indifferent to surrounding things and people, some may have problems in getting along with others and cannot take into account the feelings of others.
    Causes: Damage to the frontal lobe with lack of emotional changes and inability to understand othesa emotion.
  • Emotional distress
    Signs: The patients tend to lose control of their emotions, cry or laugh easily that are hard to stop. They are usually easily agitated and complicated with no self-worth, lack of self-confidence, and prone to develop depression and anxiety.

Treatment and management

In addition to brain surgery and medication, multidisciplinary rehabilitation also plays a crucial role.

• Physiotherapy
  Use appropriate manual techniques, rehabilitative instrumentation, and therapeutic exercises to maintain or restore physical function, reduce complications, and minimise impact of the injuries on functional abilities and quality of life through pain management, cardiopulmonary reconditioning, balance and mobility recovery, etc.
• Occupational therapy
  Therapeutic intervention for upper limb recovery together with the prescription and training of assistive aid and environmental adaptations for maximising participation in daily living. And use in conjunction with cognitive training in the context of self-care and leisure activities to improve the patients’ ability to cope with the needs of their premorbid role.
• Speech therapy
  Use appropriate aid and therapeutic intervention to improve swallowing and eating functions as well as communication abilities and skills.
• Nursing
  Help patients in managing urinary catheterization, diaper, feeding tube, stoma and skin care as well as effectively managing medications.
• Nursing Psychosocial support
  Help patients and caregivers to understand and accept the present functioning and actively face and deal with the cognitive, emotional, and behavioral changes.